Agenda and minutes

The Chair welcomed everybody to the meeting.

Apologies were received from:-

-        Jonathan Dyson

-        Mike Padgham (subbed by John Pattison)

-        Stuart Coulter

-        Louise Wallace

-        Zoe Campbell (subbed by David Kerr)

Resolved –

That the Minutes of the meeting held on 22^nd May 2024 be approved.

There were no declarations of interest.

Members of the public may ask questions or make statements at this meeting if they have given notice to Christian Brennan of Democratic Services and supplied the text by midday on 15/07/2024, three working days before the day of the meeting.  Each speaker should limit themselves to 3 minutes on any item.  Members of the public who have given notice will be invited to speak:-

·         at this point in the meeting if their questions/statements relate to matters which are not otherwise on the Agenda (subject to an overall time limit of 30 minutes);

·         when the relevant Agenda item is being considered if they wish to speak on a matter which is on the Agenda for this meeting.

If you are exercising your right to speak at this meeting, but do not wish to be recorded, please inform the Chair who will instruct anyone who may be taking a recording to cease while you speak.

There were no public questions.

Richard Webb updated the Board, as summarised below:-

-          That there were ongoing issues with financial planning and key NHS milestones.

-          West Yorkshire ICB had considered the effects arising from the new government manifesto commitments and the Kings Speech.

-          A meeting between Bradford and Craven and Lord Markham regarding Erdale Hospital rebuilding programme had been deferred to a later date. Local Members were speaking to the NHS about the emergent consequences.

-          Lancashire and South Cumbria were in ongoing discussions regarding the Place Board arrangements, of which North Yorkshire Council (NYC) had been involved in.

Richard also complimented Nancy O’Neill for her more than 40 years of service in the NHS, but would now be leaving the organisation. The Board agreed that a letter of gratitude would be sent to Nancy on behalf of the Board.

Nancy O’Neill, who had joined the meeting later, presented her update as summarised below:-

-          That in addition to changes brought by the new government, they would be looking forward to the Autumn spending review and its implications.

-          The junior doctor industrial action had not caused any adverse effects to the safety of patients but had impacted routine appointments.

-          There was a review of the West Yorkshire infrastructure strategy which included proposals on many projects such as Skipton Hospital, Erdale Hospital, and Settle.

Christian Turner presented his update to the Board, as summarised below:-

-          Out of 11.2 million GP appointments across the integrated care system (ICS), 2.8 million were within North Yorkshire, a 9% increase from the previous year.

-          Long waits had started to come down.

-          There were improvements in users of urgent and emergency care being seen within four hours however this was still below the national target of 76%.

-          Stephen Eames had convened an emergency care summit in June. Chief Executives, Place Directors, and key leads from across the ICS met to discuss how to improve performance and avoid more users being transferred to emergency care. The plan that emerged from the summit was being developed, to be ready for Winter.

-          There was a backlog in cancer treatments which was now coming down. In North Yorkshire over 1200 people had completed their cancer path, a total of 7 fewer than the previous year.

-          There was significant investment coming into health inequalities which in North Yorkshire was being managed by Locality Care Partnerships. The model that had been deployed had been effective in understanding issues at the local level.

-          Within North Yorkshire 2000 people with disabilities had their annual mental health check last year, an improvement on the previous year.

-          In community services there had been a growth of virtual wards which had become an important part of the overall system as they have enabled people to leave hospital sooner than they otherwise would have.

The Chair asked for information regarding dentistry and the issues around deprived areas losing access due to the transfer of contracts. Christian advised that it was an issue across the ICS but there was work being done to find ways to become more flexible with the funding that was available and contracts in place. Sally Tyrer, Chair of the Primary Care Collaborative for North Yorkshire and York, added that the partners involved had shown an understanding of the issues. The ICS had shown innovative ideas in dealing with the issues, such as tackling health inequalities through offering ‘golden hellos’ to dentists.

Ashley Green added that it was positive the new government would look at dental contracts, and was optimistic towards the impact new training hubs could have across the ICS. In addition, he mentioned that the four biggest queries from the public were regarding dentistry, mental health, GP access, and waiting times.

Richard Webb provided his update, as summarised below:-

1.     The Change in government

-          The big issues were housing, house building, growth, and further devolution to mayoral authorities.

-          That there may be a royal commission on social care.

-          Anti-smoking legislation had been revived.

-          The Adult Social Care Work Force Strategy had been published.

2.     System Issues

-          Colleagues in the Harrogate and District Foundation Trust had renewed the integrated service for another year which would now focus more on intermediate care, as well as front door and back door prevention of admission to  ...  view the full minutes text for item 7.

Vic Turner, Public Health Consultant, presented her report to the Board. As background she said the report was representative of the North Yorkshire Health Protection Group (HPAG) and provided strategic oversight on Health Protection across the whole the system. The report was intended to tighten up some of the assurance processes and plan for the next series.

In her presentation she highlighted:-

Update on 23/24 Priorities

-          The Implementation of the School Immunisation Service had move across to Vaccinations UK.

-          Health Protection had benefitted from LGR merger of Environmental Health and Public Health into one organisation.

-          A Military Health Liaison Group had its first meeting. Further, that a link to the group would be developed as military health was a key issue at the moment.

Screening and Immunisations

-          There were good links between the public health UKHS IBC.

-          Work was ongoing with awareness campaigns.

-          Health Inequalities was being considered, especially in Scarborough.

Infection Prevention and Control

-          They were reviewing the specification around the IPC.

-          A new service was expected to be in place from the 1^st January, 2025 and feature a new specification.

Sexual Health

-          Its provision continued to be provided by York Sexual Health

-          The Health Protection Assurance Board had been linked up with the relevant Board on sexual health.

-          Sexual Health data was now reported through HPAG.

Environment

-          Seasonal health was a key issue due to a changing climate.

-          The Cold Weather Plan was replaced by the Adverse Weather Plan.

-          A North Yorkshire website was set up to include messaging from all partners of seasonal health.

-          ICB money had been used to appoint to post a seasonal health role.

-          Collaboration between environmental health and public health was easier due to the merger into one organisation.

Emergency Preparedness, Resilience, and Response

-          The Local Resilience Forum (LRF) for York and North Yorkshire had a three year cycle in reviewing its risks and plans, and had featured health in the previous year.

-          The two health related risks of particular interest were around pandemics and emerging infectious diseases. A new strategic plan had been developed for the LRF around the two highlighted risks, and would sit above the operational plans held at the council level.

-          They held an exercise in February which had gone well.

-          The findings of the Covid Inquiry would factor into the new model of the LRF such as messaging around preparing for the wrong pandemic. This involved taking a more holistic approach to pandemics due to similarities in deploying testing, vaccinations, contact tracing etc. There should also be particular interest in routes of transmission.

Incidents and outbreaks.

-          There had been two major incidents in the past 12 months.

-          The first was a mass bird die off on the coasts of Scarborough and Filey and had posed challenges as it was on a public beach in a non-controlled area and did not receive a response from  ...  view the full minutes text for item 8.

Saskia Calton, Head of Finance for Public Health, Partnerships and Projects presented her report to the board.

As background, she said the Better Care Fund (BCF) report pulled together budgets from the NHS and Local Government to deliver the integration of health and social care. The fund was brought together under the BCF framework but was allocated to individual partners and contained within each of the organisation’s budget allocations, as shown in appendix 1. This was represented by 84 schemes in 24/25 and had a total budget of £83.5 million. She summarised aspects from the report regarding the Better Care Fund update 24/25 and 23/24 Outturn monitoring return.

The Chair thanked Saskia for her report. He shared that health and adult services, and local authority colleagues had continued to express their frustration that so much of their funding came from so many different strands of better care funding.

Richard Webb said it was a complex picture with many organisations. The fund was twice the amount it was compared to when it stared and delivered front line improvements to services.

Resolved –

That the Better Care Fund Planning Update Submission for 2024/2025; and The Quarterly Outturn return for the final quarter of 2023/2024 be approved.

Any other items which the Chair agrees should be considered as a matter of urgency because of special circumstances

There was no other business.

Friday 18^th September 2024 at 1.30 p.m.

The Chair introduced the report and invited Members to make additions to the Work Programme.

NOTED.